Prior Authorization Lookup
Please note:
- This tool is for outpatient services only.
- Inpatient services and nonparticipating providers always require prior authorization.
- This tool does not reflect benefits coverage* nor does it include an exhaustive listing of all noncovered services (i.e., experimental procedures, cosmetic surgery, etc.)— refer to your provider manual for coverage/limitations.
*Services may be listed that are not covered benefits, whether they do or do not require precertification. Verify benefit coverage prior to rendering services.
To determine coverage of a particular service or procedure for a specific member:
Step 1:
Access eligibility and benefits information on the Availity Portal or call Provider Services at 1-844-462-0022.
Step 2:
Use the Prior Authorization tool above or within the Availity Portal.
Step 3:
If the service/procedure requires preauthorization, visit the Availity Portal.
To request authorizations:
- From the Availity home page, select Patient Registration from the top navigation.
- Select Auth/Referral Inquiry or Authorizations.